NPIMap

Individual provider Active NPI

Andrew W Lazos, PA-C

  • Physician Assistant
  • Sequim, WA
National Provider Identifier
1043941289
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61310949 Issued in WA
Practice address
800 N 5TH Ave Ste 101
Sequim, WA 98382-3045
Phone
(360) 565-0999
Fax
(360) 582-4221
NPI assigned
Jun 20, 2022
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA61310949 WA Primary

Addresses

Primary practice location

800 N 5TH Ave Ste 101
Sequim, WA 98382-3045

Mailing address

PO Box 850
Port Angeles, WA 98362-0146
Phone (360) 565-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220812002869 WA Practitioner - Physician Assistant 4587047212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Olympic Medical PhysiciansGroup PAC ID 9537172358, 106 clinicians

Practice addresses (Care Compare)

800 N 5TH Ave
Suite 101
Sequim, WA 98382-3045
Phone (360) 565-0999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.56 of 100Reported as group
Quality
80.73
Promoting interoperability
80
Improvement activities
40
Cost
74.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61310949WAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: alazos2440999@wm.providencedirect.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1043941289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620146",
            "telephone_number": "360-565-0999",
            "fax_number": "360-565-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N 5TH AVE STE 101",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823045",
            "telephone_number": "360-565-0999",
            "fax_number": "360-582-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZOS",
        "first_name": "ANDREW",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61310949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sequim, WA

Sources for this page

Verify at the official NPI Registry.